| NPI | 1073911608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801082567) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 68-01082567) |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2021-09-14 |